UNASSIGNED:设计先天性门体分流血管内闭合的前瞻性研究。主要终点是评估腔内封堵术的安全性。次要终点是评估临床,治疗的分析和影像学结果。
UNASSIGNED:15例患者(年龄范围:2天至21岁;10例男性)因先天性门体分流被转诊至我们中心。治疗前收集以下数据:年龄,性别,病史,临床和分析数据,尿三甲氨基尿症,腹部-美国,和身体CT。在干预时收集以下数据:分流的解剖和血液动力学特征,使用的设备,成功关闭。在干预后的各个时间点收集了以下数据:住院期间(确认分流闭合并检测并发症)和一年后(对于临床,分析,和成像目的)。
UNASSIGNED:12名参与者的治疗是成功的,在两个中观察到设备的迁移,而急性内脏血栓形成在一个。标签外设备用于尝试关闭并排分流器,使用Amplatzer™Ductus-occluder和Amplatzer™肌-血管间隔缺损-occluder取得了成功。主要变化为:凝血酶原活性增加(p=0.043);AST降低,ALT,GGT,和胆红素(p=0.007,p=0.056,p=0.036,p=0.013);血小板减少症消退(p=0.131);门静脉扩张(p=0.005);多普勒门静脉血流正常化(100%);肝结节消退(p=0.001);氨正常化(p=0.003);三甲氨尿消失(p=0.285)。
UNASSIGNED:血管内封闭是有效的。我们的结果支持左右分流和先天性门静脉缺失的血管内闭合的指征。
UNASSIGNED: To design a prospective
study on endovascular closure of congenital portosystemic shunts. The primary endpoint was to assess the safety of endovascular closure. The secondary endpoint was to evaluate the clinical, analytical and imaging outcomes of treatment.
UNASSIGNED: Fifteen patients (age range: 2 days to 21 years; 10 male) were referred to our center due to congenital portosystemic shunts. The following data were collected prior to treatment: age, sex, medical history, clinical and analytical data, urine trimethylaminuria, abdominal-US, and body-CT. The following data were collected at the time of intervention: anatomical and hemodynamic characteristics of the shunts, device used, and closure success. The following data were collected at various post-intervention time points: during hospital stay (to confirm shunt closure and detect complications) and at one year after (for clinical, analytical, and imaging purposes).
UNASSIGNED: The treatment was successful in 12 participants, migration of the device was observed in two, while acute splanchnic thrombosis was observed in one. Off-label devices were used in attempting to close the side-to-side shunts, and success was achieved using Amplatzer™ Ductus-Occluder and Amplatzer™ Muscular-Vascular-Septal-Defect-Occluder. The main changes were: increased prothrombin activity (p=0.043); decreased AST, ALT, GGT, and bilirubin (p=0.007, p=0.056, p=0.036, p=0.013); thrombocytopenia resolution (p=0.131); expansion of portal veins (p=0.005); normalization of Doppler portal flow (100%); regression of liver nodules (p=0.001); ammonia normalization (p=0.003); and disappearance of trimethylaminuria (p=0.285).
UNASSIGNED: Endovascular closure is effective. Our results support the indication of endovascular closure for side-to-side shunts and for cases of congenital absence of portal vein.